Lower extremity traumatic amputations—brief review of reconstruction, wound and soft tissue management, alternatives to conventional practice

Christian W. Ertl


While initial trauma care will always focus on preservation of life limb eyesight bleeding control and stabilization, those patients with traumatic amputees often have a less than optimal outcome, as there is overwhelming focus on wound closure and less on functionality. While trauma care will should focus on stabilization and bleeding control we would submit that a prospective approach to a traumatic amputee would allow longer limb length or preservation of tissue for reconstructive outcomes that would enhance their recovery and rehabilitation, we have adopted the use of osteomyoplastic reconstruction in her amputees as well as using full-thickness skin grafting in addition to advanced wound techniques to improve functional return for our traumatic amputees. Additionally, use of rigid removable dressings offers protection in-line stabilization neutral positioning of the joint as well as compression and we regularly employ them and amputee treatment and wound care. The staging of traumatic amputees wound management debridement and final skin closure follows lessons learn from the wars in Iraq and Afghanistan lysing the “ladder of reconstruction”. Which has demonstrated that there are more functional outcomes even for poly-traumatized patients.